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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Aortic valve sparing root surgery for Marfan syndrome
George Matalanis1, Nisal K Perera1
1Department of Cardiac Surgery, The Austin Hospital, Heidelberg, Australia.
Annals of Cardiothoracic Surgery
|December 23, 2017
Summary
Aortic valve sparing root surgery (AVSRS) offers a safe and durable alternative for aortic regurgitation (AR) and dilated roots. It provides equal outcomes in Marfan syndrome (MFS) patients, avoiding prosthetic valve complications.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Aortic Root Pathology
Background:
- Aortic valve sparing root surgery (AVSRS) is a viable alternative to prosthetic valves for dilated aortic roots or aortic regurgitation (AR).
- Retaining the native aortic valve avoids risks associated with prosthetic valves, such as anticoagulation and degeneration.
- AVSRS demonstrates comparable outcomes in Marfan syndrome (MFS) patients despite theoretical concerns about tissue fragility.
Purpose of the Study:
- To demystify the structure-function interactions of the aortic valve for AVSRS.
- To provide an intuitive understanding of AVSRS principles.
- To elaborate on successful technical details for long-term native aortic valve preservation.
Main Methods:
- Review of established AVSRS techniques.
- Analysis of structure-function relationships in aortic valve engineering.
- Surgical armamentarium for native valve preservation.
Main Results:
- AVSRS is safe and durable for dilated roots and AR, avoiding prosthetic valve complications.
- Outcomes of AVSRS in Marfan syndrome (MFS) are comparable to non-MFS patients.
- Preserving the native valve simplifies management for future procedures in younger patients.
Conclusions:
- AVSRS is an effective treatment for AR and dilated aortic roots, particularly beneficial for younger patients.
- Understanding aortic valve biomechanics is crucial for successful AVSRS.
- Established surgical techniques can achieve durable native aortic valve function in MFS and other populations.
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